... as developed by the Secretary ... as established by the Secretary ... as identified by the Secretary Have you considered the implications of that? The named "secretary" is subject to radical philosophical change every 4 years or sooner. And Congress didn't WRITE a health care bill. NOOOOO.. they haven't written real law for a couple decades. They've delegated the actual implementation to ONE OFFICE of the bureaucracy. Happy with that? Want to see the policies change on the medical decisions you and your doctor make as admins change? THOUSANDS of important aspects of that "law" are left to winds of political change. How stupid are we really?